What is a Grand Mal Seizure?

Misty Wiser

A grand mal seizure is characterized by a loss of consciousness, muscle rigidity, and rhythmic muscle contractions. It is also known as a tonic-clonic seizure. In the first phase of a grand mal seizure, the body becomes rigid and the person loses consciousness. The second phase is the convulsion phase, when muscles of the body contract and relax repeatedly for about one to two minutes. A physician should be consulted about any seizure episodes.

A person suffering a grand mal seizure loses consciousness during the tonic phase.
A person suffering a grand mal seizure loses consciousness during the tonic phase.

The grand mal seizure is caused by a series of electrical imbalances in the brain. Epilepsy, a seizure disorder, is the most common cause of seizures. Low levels of magnesium, glucose, sodium or blood calcium may cause abnormal rhythmic electrical signals to transmit across the surface of the brain. Seizures can be caused by a head injury, a lack of oxygen, or even a stroke. A current or previous meningitis infection also causes seizures.

Some people experience warning signs before a grand mal seizure. These are called auras, and may include different sensory perceptions, such as an odd smell or unusual lights. Sometimes the air is forced out of the vocal cords at the beginning of a seizure causing a scream like sound followed by rigidity and convulsions. After a seizure, many people experience a lasting headache and extraordinary fatigue.

During a grand mal seizure, it is not uncommon for a person to lose control of his bowels and bladder. His jaw may clench together and he may bite the inside of his mouth. Sometimes a person may stop breathing while the convulsion phase of the seizure is happening, resulting in a temporary bluish color to the skin.

It is not safe to place an object in a person’s mouth that is having a grand mal seizure. The risk of choking on the object is greater than the risk of a biting injury to their tongue or mouth. When someone is having a seizure, try to roll him on his side and place a pillow under his head. Notify medical professionals that a person is having a seizure immediately upon recognizing the symptoms.

Treatment for grand mal seizures depends on the underlying cause. A few people have seizures when withdrawing off illegal drugs, or from the excessive consumption of alcohol. Some people who have a grand mal seizure never experience another one. Those whose seizures are caused by epilepsy will need to take a daily medication to prevent or reduce the occurrence of additional seizures.

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Discussion Comments


An epileptic 15 year old drowned. He suffered from grand mal seizures. Would he have experienced the same pain and mental anguish as an ordinary person even for some seconds as his attack proceeded? His twin brother says that he did not lose consciousness until between 1 to 2 minutes. Always felt impending attack. Any help would be appreciated regarding this question. --Peter

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